Why Do I Care?
- page 3

Why do I care that new nurses leave our unit after less than two years -- often after less than one year? Why do I care, when they're adults. They're going to have to live with the consequences of...
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All I'm seeing in this post is, "I care because it makes my job more difficult." I really thought this was going to be about how patient care is made more difficult and potentially less safe by a nurse constantly being in charge of the patients and preceptees in a high-acuity environment, but it's all about how "demoralizing" and "heartbreaking" the job is for the seasoned nurses where you work.

Please -- if you have something to add about the subject of new nurses jumping ship immediately and how patient care is made potentially less safe, contribute it. I'd love to read it.

This happens in a lot of facilities even great ones and great units like the ones I have worked in. I have come to accept it as part of the job. Staying for more than 2 years seems to be the rarity and part of me thinks those who stay much longer are looked at with disdain or viewed as less ambitious (?) even by management. stagnant(?) Does anyone else get that feeling?

The common denominator is the unit, not the new grads. If there is high turnover rate, blame it on the unit, not the new nurses. Too many units treat their nurses like disposable crap, don't give their new nurses enough time in orientation, and don't provide a contract to give a person an incentive to stay at a job.

Until a contract is made between new grads and hospitals, I highly doubt anything can be done. I have had the opportunity to work at great facilities and awful ones. The great ones give new grads extensive orientation and tons of support and resources. At my clinicals a couple days ago, I was talking to a nurse who has worked at the unit for three years. Her orientation was sixteen weeks, but the hospital wouldn't hesitate to give a new nurse twenty or more weeks to ensure that she/he feels comfortable in his/her new role.

I would be FAR more inclined to stay at a job for AT LEAST three years if THEY invested in four, five months training and orienting to help me feel more comforable and secure versus two or three weeks of a crappy orientation and being thrown to the wolves and expected to know it all. The places with high turnover rates typically don't invest a lot in their new nurses. A three week orientation for a new grad isn't sufficient for even the smartest and brightest of the crop, much less for the average new grad.

That being said, if you are tired of orienting new grads, then talk to management and put your foot down. You are misplacing your anger and frustration. If your unit is losing new grad after new grad, there is something wrong on their end because I can assure you that not all of those new grads are racing to NP or CRNA school or even their dreeeaaammmm job.

Orientation for new grads in my unit is six months; more if we feel that the new grad would be a good fit for the unit and just need more time. It's the best orientation program I've seen in 35 years of nursing. We have nurse educators, classes, a simulation lab -- all the support and resources you could think of and some that would not have occurred to me. I don't know what more we as a unit could do to get new grads to stay . . . a contract has to occur above the unit level.

My frustration is not misplaced. It's not the institution or the unit I work on. It's the culture among new grads that say "I'll do what I want and it's no concern of yours," or "I'm going to do the best I can for MEEEE, and you're not my concern." I'm not saying all or even most new grads suscribe to that culture, but you see it here an awful lot.

Cheezus, what a lot of hand-wringing, ginned-up drama about what's essentially bad procedure & protocol on the part of the hospital management.

Ruby, I get that you really caaaaaaaaaaare about high turnover of new nurses and it brrrrrrrrrreaks your heart when good ones leave quickly. Sure, that sucks. But you seem a little obsessive about what's essentially a long-standing fact of nursing and our economy as it is today. Don't get me wrong, I'm in agreement with you that the younger generation seem bafflingly nonchalant about many aspects of job security and seem to blithely make decisions purely based on their comfort levels. Yep. I hear ya.

But this constant moaning about the endless conveyor belt of preceptees who can't commit, and shatter your hardworking, idealistic soul over and over again, despite your grand and altruistic efforts to teeeeeeeeeeeach them what nursing is all about, and THEN following up with petulant, defensive blowback when anyone dares to ask why is this of such importance to you, not only makes you and your COB buddies look like judgmental nannies, it also gives an impression that you'd rather play the role of hapless, pious victim rather than modeling accountability.

Your two recent posts about this issue sound like a warped 45 of "Ballin' The Jack" played at 33 1/2. Seriously. I respect your COB status but I'm also an experienced nurse. If this new grad turnover problem is soooooooooooo heart shattering to your exhausted, giving, concerned soul, over and over, and impacting patient care. then for cat's sake, go to management. Do some impact studies. Gather data. Develop a retention plan. Hire a contract consultant. Use your COB status to role model ACTION to us younger nurses, not WHINING and playing helpless toady. Talk about reinforcing unfortunate stereotypes about nurses!

I want to hear about your plan of action to solve this problem. Tell us what steps you've taken, what works, doesn't work, might work. Use your wisdom and experience to be an agent of change. Wouldn't that be a little more constructive than essentially berating an entire generation of new nurses, insulting other people's choices, pretending you're powerless to your hospital's lack of contract practice, and being snappishly defensive to anyone who dares critically think about your posts? Come on, Ruby. I love your contributions to this board, but good lord. You seem bored.

Cheezus, what a lot of hand-wringing, ginned-up drama about what's essentially bad procedure & protocol on the part of the hospital management.

Ruby, I get that you really caaaaaaaaaaare about high turnover of new nurses and it brrrrrrrrrreaks your heart when good ones leave quickly. Sure, that sucks. But you seem a little obsessive about what's essentially a long-standing fact of nursing and our economy as it is today. Don't get me wrong, I'm in agreement with you that the younger generation seem bafflingly nonchalant about many aspects of job security and seem to blithely make decisions purely based on their comfort levels. Yep. I hear ya.

But this constant moaning about the endless conveyor belt of preceptees who can't commit, and shatter your hardworking, idealistic soul over and over again, despite your grand and altruistic efforts to teeeeeeeeeeeach them what nursing is all about, and THEN following up with petulant, defensive blowback when anyone dares to ask why is this of such importance to you, not only makes you and your COB buddies look like judgmental nannies, it also gives an impression that you'd rather play the role of hapless, pious victim rather than modeling accountability.

Your two recent posts about this issue sound like a warped 45 of "Ballin' The Jack" played at 33 1/2. Seriously. I respect your COB status but I'm also an experienced nurse. If this new grad turnover problem is soooooooooooo heart shattering to your exhausted, giving, concerned soul, over and over, and impacting patient care. then for cat's sake, go to management. Do some impact studies. Gather data. Develop a retention plan. Hire a contract consultant. Use your COB status to role model ACTION to us younger nurses, not WHINING and playing helpless toady. Talk about reinforcing unfortunate stereotypes about nurses!

I want to hear about your plan of action to solve this problem. Tell us what steps you've taken, what works, doesn't work, might work. Use your wisdom and experience to be an agent of change. Wouldn't that be a little more constructive than essentially berating an entire generation of new nurses, insulting other people's choices, pretending you're powerless to your hospital's lack of contract practice, and being snappishly defensive to anyone who dares critically think about your posts? Come on, Ruby. I love your contributions to this board, but good lord. You seem bored.

The goal = Make the unit so awesome that nurses pile ten deep to fill out applications for a 1 in 50 shot at the job. Look to those who are doing it well and incorporate that culture. Replicate the format. Not rocket science.

Cheezus, what a lot of hand-wringing, ginned-up drama about what's essentially bad procedure & protocol on the part of the hospital management.

Ruby, I get that you really caaaaaaaaaaare about high turnover of new nurses and it brrrrrrrrrreaks your heart when good ones leave quickly. Sure, that sucks. But you seem a little obsessive about what's essentially a long-standing fact of nursing and our economy as it is today. Don't get me wrong, I'm in agreement with you that the younger generation seem bafflingly nonchalant about many aspects of job security and seem to blithely make decisions purely based on their comfort levels. Yep. I hear ya.

But this constant moaning about the endless conveyor belt of preceptees who can't commit, and shatter your hardworking, idealistic soul over and over again, despite your grand and altruistic efforts to teeeeeeeeeeeach them what nursing is all about, and THEN following up with petulant, defensive blowback when anyone dares to ask why is this of such importance to you, not only makes you and your COB buddies look like judgmental nannies, it also gives an impression that you'd rather play the role of hapless, pious victim rather than modeling accountability.

Your two recent posts about this issue sound like a warped 45 of "Ballin' The Jack" played at 33 1/2. Seriously. I respect your COB status but I'm also an experienced nurse. If this new grad turnover problem is soooooooooooo heart shattering to your exhausted, giving, concerned soul, over and over, and impacting patient care. then for cat's sake, go to management. Do some impact studies. Gather data. Develop a retention plan. Hire a contract consultant. Use your COB status to role model ACTION to us younger nurses, not WHINING and playing helpless toady. Talk about reinforcing unfortunate stereotypes about nurses!

I want to hear about your plan of action to solve this problem. Tell us what steps you've taken, what works, doesn't work, might work. Use your wisdom and experience to be an agent of change. Wouldn't that be a little more constructive than essentially berating an entire generation of new nurses, insulting other people's choices, pretending you're powerless to your hospital's lack of contract practice, and being snappishly defensive to anyone who dares critically think about your posts? Come on, Ruby. I love your contributions to this board, but good lord. You seem bored.

When I read Ruby's initial post about nurses leaving shortly after being hired, I read it as : she sees all these posts on AN where nurses she never met in real life are whining, unhappy, leaving a job after a short time, and why would she take it personally. This post clarifies why : these are nurses on her own unit, many of whom she has precepted.
High turnover affects morale. It affects patient care.
One thing I have read recently (and I am not in a position to hire, fire, or anything like that) is: "hire for attitude, train for skill."
What I like about that is, as many of those responding here have brought out, is it brings out that if your intention is to leave in a year, or two years, why work in a place with such a long learning curve as ICU? A new hire should mesh with the culture where he or she is hired. Certainly, some people will leave after a short time due to other factors. By and large, however, people should be hired to fit into the unit.
My workplace is not ICU by any means, but it is certainly not for everybody. For a while our new hires were leaving after a month or two due to being a poor fit. We made some changes to the hiring process that put this to a halt. Now, people are by and large staying a long time (in some cases, longer than they should...another subject entirely!).

When I read Ruby's initial post about nurses leaving shortly after being hired, I read it as : she sees all these posts on AN where nurses she never met in real life are whining, unhappy, leaving a job after a short time, and why would she take it personally